When I published my post earlier about the ways we keep our pain silent, one of the patient advocates I deeply admire responded to my post. And what she said reflects a truth I often hear in the office. It still hurt to hear.

Women of Teal ‏@womenoftealThere are those that think we are complaining because you can’t “see” pain and other side effects but still disabling 4 us.

When did our attitude shift so that telling the truth about painful experiences or pain itself is identified as complaining? How did the “positive attitude” become a mandate rather than a goal? Listen, I’m a psychologist. I am a brain science geek. I truly believe that finding and fully experiencing the moments of joy and comfort in our lives is important. I use gratitude journals and happy moments practice as therapy homework assignments. I am passionate about the possibility of people moving toward more brain and body health. I understand that sometimes we have to challenge ourselves to move and reach and risk–even in the face of pain.

But here’s the thing. While I believe that pain does not have to be the complete definition of our existence, I understand that pain is real. I understand that fatigue, depression, pain, and anxiety are not going to be banished by our will alone.

The expectation that people who are coping with chronic illness, of any stripe, should never talk about the hard parts of their life experience is just absurd. Chronic illness is a constant companion. If you are fortunate, your chronic illness may be well managed by lifestyle choices and medication. But even “well-managed” illnesses take a toll. So many of my clients are choosing between the progression of their illness or taking a medication that has significant negative side effects. And when you live with chronic illness, you can never be certain that you won’t have a “crash” day.

It does not support health to dismiss people’s experiences as “complaining.” It does not support health to diminish someone’s truth because it does not match your expectation of how things go. It does not support health to buy into healthy privilege and the assertion that health is a manifestation of virtue.

It is expectations like this, that people should suffer in silence in order to deserve our support, that further the many layers of stigma surrounding physical and mental illness.

So let’s talk about how we can create moments–in health care and in society–where we truly listen to the experiences people are having. When we trust that they are describing the truth of their experience. And where we choose to offer compassion instead of judgment.